1. Field of the Invention
The present invention relates to methods of treatment, especially for treating allograft rejection, with pharmaceutical compositions, particularly with mycophenolic acid, the morpholinoethyl ester thereof and certain simple ester derivatives of the phenolic hydroxyl group. Methods of treatment for autoimmune diseases, such as diabetes are also disclosed.
2. Background Information and Related Disclosures
Inflammatory diseases, in particular rheumatoid arthritis, have been treated with a variety of compounds repressing several structural classes and biological activities, including, for example, anti-inflammatory agents (corticosteroids, aspirin, derivatives of arylacetic and arylpropionic acids, and oxicams), immunosuppressive agents and regimens (methotrexate, cyclophosphamide, cyclosporin, and total lymphoid irradiation), and long-acting anti-rheumatic drugs (gold salts, and penicillamine and its derivatives). However, no representative of any of these classes of compounds is regarded as ideal.
Mycophenolic acid is a weakly-active antibiotic found in the fermentation broth of Penicillium brevicompactum. Some compounds relating to mycrophenolic acid, and their uses in the treatment of inflammatory diseases, such as rheumatoid arthritis, are disclosed in the following two prior related applications.
Ser. No. 803,041, filed Nov. 27, 1985, relates to compounds having the general structure of Formula 1: ##STR2## and the pharmaceutically acceptable salts thereof, where: R.sub.1 is H or lower alkyl having 1 to 6 carbon atoms;
R.sub.2 is H, lower alkyl having 1 to 6 carbon atoms or -phenyl-4-CO.sub.2 R.sub.3, in which R.sub.3 is H, lower alkyl having 1 to 6 carbon atoms or a pharmaceutically acceptable cation; PA0 R.sub.4 and R.sub.5 are each independently H or lower alkyl having 1 to 6 carbon atoms; PA0 X.sub.1 and Y.sub.1 are each independently O or S; and PA0 q is an integer of 1-6. PA0 R.sub.1 is selected from the group consisting of: ##STR4## in which: A.sub.1 is oxygen or sulfur; PA0 q is an integer form 0-6; PA0 R.sub.2 is alkyl, haloalkyl or --NR.sub.4 R.sub.5, where: R.sub.4 and R.sub.5 are independently H, alkyl, haloalkyl, cycloalkyl, phenyl optionally monosubstituted with halogen, hydroxy, carboxy, chlorocarbonyl, sulfonylamino, nitro, cyano, phenyl, alkyl, acyl, alkoxycarbonyl, acylamino, dialkylamino or dialkylaminoethoxycarbonyl, phenyl optionally disubstituted with hydroxy, carboxy, notro or alkyl, or benzyl optionally substituted with dialkylamino; PA0 R.sub.3 is H, alkyl or a pharmaceutically acceptable cation; PA0 Q and Q.sub.1 are independently H or --CO.sub.2 R.sub.3 ; and PA0 Z.sub.1 is selected from the group consisting of: IH-tetrazolyl, --CH.sub.2 OH, --CHO, --CN, --C(O)A.sub.2 R.sub.6 and --C(O)NR.sub.7 R.sub.8, in which: PA0 A.sub.2 is oxygen or sulfur; PA0 R.sub.6 is H, alkyl, alkenyl, cycloalkyl, optionally substituted phenyl, optionally substituted benzyl or a pharmaceutically acceptable cation; and PA0 R.sub.7 and R.sub.8 are independently H, alkyl or cycloalkyl, or R.sub.7 and R.sub.8 taken together are --(CH.sub.2).sub.2 O(CH.sub.2).sub.2 --, --(CH.sub.2).sub.4 --,m or --(CH.sub.2).sub.5 --; PA0 Z is hydrogen or --C(O)R, PA0 where R is lower alkyl and aryl,
Ser. No. 821,633, filed Jan. 23, 1986, relates to compounds having the general structure of Formula 2: ##STR3## and the pharmaceutically acceptable salts thereof, where: A is oxygen or sulfur;
with the proviso that R.sub.1 and R.sub.6 cannot both be H if A and A.sub.2 are oxygen.
Compounds somewhat structurally similar to the compounds of Formulae 1 and 2 are described in U.S. Pat. Nos. 3,705,894; 3,853,919; 3,868,454; 3,880,995, in Japanese Patent No. J 57024380, in J. Antibiot., 293), 275-85, 286-91 (1976), and in Cancer Research, 368), 2923-7 (1976). The disclosed compounds are described as having anti-tumor, immunosuppressive, anti-viral, anti-arthritic and/or anti-psoriastic activities.